[Correlation of carbon dioxide derived parameters during cardiopulmonary bypass with acute kidney injury after pediatric cardiac surgery].

Objective: To explore the correlation of the ratio of venous-arterial carbon dioxide (CO2) tension difference to arterial-venous O2 content difference (Pv-aCO2/Ca-vO2) and venous-arterial CO2 gradient (Pv-aCO2) during cardiopulmonary bypass (CPB) with acute kidney injury (AKI) after pediatric cardiac surgery. Methods: The clinical data of children (1 month ≤ age ≤ 3 years old) who underwent open heart surgery under CPB in West China Hospital of Sichuan University from March 2021 to August 2022 were retrospectively analyzed. All paired blood gases of the children during CPB (the sampling time interval of arterial and venous blood was within 10 minutes) were collected. According to the Failure, Loss, End-Stage Renal Disease (pRIFLE) diagnostic criteria, the children were divided into AKI group and non-AKI group. Multivariate logistic regression analysis was performed to identify the risk factors of postoperative AKI in pediatric cardiac surgery. Results: A total of 213 children were enrolled (101 males and 112 females), aged 12(6, 24) months, and 84 of them (39.4%) developed AKI. Three children died in AKI group, with a mortality of 3.6%. There were no deaths in non-AKI group. The incidence of postoperative low cardiac output syndrome (LCOS) was higher in AKI group [29.8% (25/84) vs 7.0% (9/129), P<0.001]. In addition, compared with the non-AKI group, children in AKI group had longer recovery time [15 (6, 78) h vs 6 (3, 19) h, P<0.001], mechanical ventilation time [17 (7, 97) h vs 6 (4, 20) h, P<0.001], intensive care unit (ICU) stay [6 (4, 11) d vs 3 (2, 5) d, P<0.001], and hospital stay [12 (9, 18) d vs 9 (8, 11) d, P<0.001]. A total of 317 arterial and venous blood gas pairs from 30 (n=207), 60 (n=75) and 90 min (n=35) after aortic clamping were included in the analysis. Univariate analysis showed that Pv-aCO2/Ca-vO2 (P=0.015) at 30 min after aortic clamping, Pv-aCO2 (P=0.041) and Pv-aCO2/Ca-vO2 (P=0.014) at 60 min after aortic clamping, peak Pv-aCO2 (P=0.009), peak Pv-aCO2/Ca-vO2 (P<0.001) and the average value of Pv-aCO2/Ca-vO2 (P=0.001) were higher in AKI group. Multivariate logistic regression analysis showed that longer duration of CPB (OR=1.013, 95%CI: 1.003-1.023, P=0.012), higher peak Pv-aCO2/Ca-vO2 (OR=1.337, 95%CI: 1.037-1.723, P=0.025) were risk factors for AKI. Conclusion: The occurrence of AKI after pediatric cardiac surgery is related to the short-term adverse clinical prognosis, and longer duration of CPB and higher peak Pv-aCO2/Ca-vO2 are independent risk factors for AKI.

[Analysis of clinical and psychological characteristics in 250 patients with fibromyalgia].

To analyze the clinical and psychological characteristics of fibromyalgia (FM), so as to further understand and improve the capability of identifying FM. The clinical data of 250 FM patients diagnosed in the outpatient clinic of the Department of Rheumatology, the First Medical Center, Chinese PLA General Hospital, from December 2019 to September 2021, were collected and analyzed. The patients aged 40 (31.0, 52.3) years, including 188 female patients (75.2%) and 62 male patients (24.8%). There was a statistically significant difference in age comparison between female [42.5 (33.0,54.0) years] and male patients [32.5 (27.8,43.5) years] (P<0.001). The score of pain degree was 6 (4, 8), and [7 (5, 8)] of female patients was higher than [6 (4, 7)] of the male patients (P=0.040). The widespread pain index (WPI) was 13 (10,15). The regions with high pain incidence were left shoulder girdle (87.2%, 218/250), right shoulder girdle (86.8%, 217/250), upper back (86.4%, 216/250), neck (79.6%, 199/250) and lower back (77.6%, 194/250) and etc. The incidence of chest pain in female patients (55.3%, 104/188) was lower than that in male patients (75.8%, 47/62) (P=0.004). The symptom severity scale (SSS) score was 8 (7-10). 74.6% (185/248) suffered from anxiety and 77.5% (193/249) suffered from depression in 249 patients. Female patients were more common in FM patients than male patients, the median age of female patients was older than that of male patients, and the median score of pain severity of female patients was higher than male patients. Shoulders girdle, upper back, neck and lower back were the most frequently reported pain regions, and the incidence of chest pain in female patients was lower than that in male patients. The incidence of major non-painful symptoms was high and the proportion with anxiety or depression was high. The above clinical features are very helpful for early diagnosis of FM.

[Clinical characteristics of 272 437 patients with different histopathological subtypes of primary esophageal malignant tumors].

Objective: To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT). Methods: A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results: A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment. Conclusion: ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Application of miniSTR Loci and Its Detection System for Degraded Materials in Forensic Medicine.

OBJECTIVES: To establish multiplex system of 16 miniSTR loci, and explore its application value for the degraded materials in forensic medicine. METHODS: The multiplex system of 16 miniSTR loci was established using a six-dye fluorescence labeling technology and its application value in forensic medicine was assessed. RESULTS: A six-dye fluorescence labeling miniSTR amplification kit was developed, which enabled 15 autosomal STR loci, Amelogenin locus and DYS391 to be typed simultaneously. This method showed good specificity and could provide stable and accurate typing results with a sensitivity of 50 pg. This system also provided a good test result for the normal biological sample of actual cases. CONCLUSIONS: The multiplex system of 16 miniSTR loci has application value for degraded and trace materials with the advantages of high sensitivity and database compatibility, which can be used for forensic casework.

An investigation into the mechanism of nobiletin's inhibition of papillary thyroid cancer using network pharmacology analysis and experimental pharmacology.

OBJECTIVE: Surgery and radioactive iodine therapy are the main treatments for papillary thyroid carcinoma (PTC), and effective drugs are lacking. As a promising natural product, nobiletin (NOB) has a wealth of pharmacological activities like anti-tumor, antivirus, and other effects. In this research, bioinformatics methods and cellular assays were combined to explore how NOB inhibited PTC. MATERIALS AND METHODS: Our NOB targets were derived from three databases, including the SwissTargetPrediction database, Traditional Chinese Medicine System Pharmacology Database, and the TargetNet server. Four databases were used to identify disease-related targets: GeneCards, PharmGkb, Online Mendelian Inheritance in Man, and DisGeNET. Finally, cross-targets of disease and drug were deemed as pharmacological targets, and they were used for GO and KEGG enrichment analysis. STRING and Cytoscape were applied for PPI Network and core Targets Ranking. Molecular docking analysis validated binding affinity values for NOB and core targets. By using cell proliferation and migration assays, NOB was assessed for its effects on PTC proliferation and migration phenotype. Western blot validated the downregulation of the PI3K/Akt pathway. RESULTS: (1) Preliminarily, 85 NOB targets were predicted for NOB intervention in PTC. (2) Our core target screening identified TNF, TP53, and EGFR, and our molecular docking results confirmed good binding between NOB and protein receptors. (3) NOB inhibited proliferation and migration of PTC cells. PI3K/AKT pathway target proteins were downregulated. CONCLUSIONS: (1) Bioinformatics analyses revealed that NOB may inhibit PTC by regulating TNF, TP53, EGFR and PI3K/AKT signalling pathway. (2) As evidenced by cell experiments, there was an inhibition of proliferating and migrating PTCs by NOB via the PI3K/AKT signalling pathway.

Author Correction: An investigation into the mechanism of nobiletin's inhibition of papillary thyroid cancer using network pharmacology analysis and experimental pharmacology.

Correction to: European Review for Medical and Pharmacological Sciences 2023; 27 (4): 1553-1564. DOI: 10.26355/eurrev_202302_31398-PMID: 36876711-published online on February 15, 2023. After publication, the authors applied some corrections to the galley proof: -       The order of Table I and II has been inverted. -       The scale bar of Figure 9A has been inserted in the Legend. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/31398.

[Effectiveness of a whole-process health education model among inpatients with ascites type of advanced schistosomiasis].

OBJECTIVE: To evaluate the effectiveness of a whole-process health education model among inpatients with ascites type of advanced schistosomiasis. METHODS: A "admission-hospitalization-discharge" whole-process health education model was created, 101 inpatients with ascites type of advanced schistosomiasis were given the whole-process health education. The scores of schistosomiasis control knowledge, attitudes towards schistosomiasis control and healthy behaviors, and awareness of schistosomiasis control knowledge, correct rate of attitudes towards schistosomiasis control and correct rate of healthy behaviors were compared among inpatients with ascites type of advanced schistosomiasis before and after implementation of the whole-process health education. RESULTS: The scores of schistosomiasis control knowledge, schistosomiasis control attitudes and healthy behaviors were all significantly higher among inpatients with ascites type of advanced schistosomiasis after implementation of the whole-process health education than before implementation (Z = -7.688, -3.576 and -4.328, all P values < 0.01). In addition, the awareness of schistosomiasis control knowledge increased from 54.3% to 82.7% (χ2 = 188.886, P < 0.01), and the correct rate of attitudes towards schistosomiasis control increased from 88.4% to 98.0% (χ2 = 22.001, P < 0.01), while the correct rate of healthy behaviors increased from 48.2% to 59.7% (χ2 = 11.767, P < 0.01). CONCLUSIONS: The whole-process health education model may remarkably improve the awareness of schistosomiasis control knowledge and promote the formation of positive attitudes towards schistosomiasis control and correct behaviors among inpatients with ascites type of advanced schistosomiasis, which is of great significance to facilitate patients' cure.

[Effect of rational emotive therapy on negative emotion in advanced schistosomiasis patients with repeated hospitalization].

OBJECTIVE: To examine the effect of rational emotive therapy on negative emotions among advanced schistosomiasis patients with repeated hospitalizations. METHODS: A total of 97 advanced schistosomiasis patients with anxiety and depressive emotions that were hospitalized in Xiangyue Hospital of Hunan Institute of Schistosomiasis Control for three times or more were enrolled, and given rational emotive therapy for 4 weeks in addition to routine nursing care. The scores for anxiety, depression and quality of life were estimated in patients before and after the rational emotive therapy using the Self-Rating Anxiety Scale (SRS), the Self-Rating Depression Scale (SDS) and WHOQOL-BREF Form. RESULTS: The SAS and SDS scores were significantly lower 4 weeks following rational emotive therapy than before the intervention (SAS score, 45.40 ± 7.77 vs. 59.25 ± 9.29, t = 14.021, P < 0.01; 51.48 ± 8.01 vs. 63.93 ± 9.59, t = 12.991, P < 0.01). The percentages of patients with moderate and severe anxiety and depression were significantly lower 4 weeks following rational emotive therapy than before the intervention (P < 0.01), and the scores for each item in the quality of life were all significantly greater 4 weeks following rational emotive therapy than before the intervention (P < 0.01). CONCLUSIONS: Rational emotive therapy may improve the negative emotions and the quality of life of advanced schistosomiasis patients with repeated hospitalizations.

Epigallocatechin-3-gallate local pre-exposure application prevents SHIV rectal infection of macaques.

Epigallocatechin-3-gallate (EGCG), a natural and major ingredient of green tea, has been shown to have anti-inflammation and anti-HIV-1 properties. We demonstrated that the intrarectal administration of EGCG could protect rhesus macaques from repetitive, intrarectal challenges with low-dose SHIVSF162P3N. This protection has a per-exposure risk reduction of 91.5% (P = 0.0009; log-rank test) and a complete protection of 87.5% (P < 0.001; Fisher's exact test). All protected animals showed no evidence of systemic and mucosal SHIV infection as demonstrated by the absence of viral RNA, DNA and antibodies. In contrast, all controls became infected after repeated SHIV challenges (a median of 2.5 times, range of 1-8 times). Mechanistically, EGCG could block the binding of HIV-1 gp120 to CD4 receptor and suppress the macrophage infiltration/activation in the rectal mucosa of macaques. These data support further clinical evaluation and development of EGCG as a novel, safe and cost-effective microbicide for preventing sexual transmission of HIV-1.

A precise interchromosomal reciprocal exchange between hot spots for cleavable complex formation by topoisomerase II in amsacrine-treated Chinese hamster ovary cells.

Among the aprt mutations induced in confluence-arrested Chinese hamster ovary D422 cells by the topoisomerase II poison amsacrine, there was a reciprocal exchange between the aprt gene and an unrelated sequence, accompanied by a chromosomal translocation at the aprt locus. The breakpoints in both parental sequences were hot spots for amsacrine-stimulated DNA cleavage in vitro, and the novel junctions formed were precisely as expected for a mechanism involving reciprocal exchange of topoisomerase II subunits followed by resealing of the breaks and correction of mismatches in the cohesive ends. The results are consistent with a role for direct subunit exchange in the production of chromosomal translocations by topoisomerase poisons, although more complex models involving double-strand breakage and repair could produce reciprocal exchanges of similar specificity.

Endemic selenium intoxication of humans in China.

An endemic disease was discovered in 1961 in parts of the population of Enshi County, Hubei Province of the People's Republic of China. During the years of the highest prevalence, from 1961 to 1964, the morbidity was almost 50% in the 248 inhabitants of the five most heavily affected villages; its cause was determined to be selenium intoxication. The most common sign of the poisoning was loss of hair and nails. In areas of high incidence, lesions of the skin, nervous system, and possibly teeth may have been involved. A case is reported of a middle-aged, female hemiplegic, whose illness and death apparently were related to selenosis. Daily dietary intakes of selenium, estimated after the peak prevalence had subsided, averaged 4.99 (range 3.20 to 6.69) mg and hair and blood selenium levels averaged 32.2 and 3.2 micrograms/ml, respectively. Up to 1000x differences occurred when selenium contents of vegetables, cereals, scalp hair, blood, and urine from the selenosis areas were compared with those from Keshan disease (selenium deficiency) areas. The ultimate environmental source of selenium was a stony coal of very high selenium content (average more than 300 micrograms/g; one sample exceeded 80,000 micrograms/g). Selenium from the coal entered the soil by weathering and was available for uptake by crops because of the traditional use of lime as fertilizer in that region. This particular outbreak of human selenosis was due to a drought that caused failure of the rice crop, forcing the villagers to eat more high-selenium vegetables and maize and fewer protein foods.

Changes in serum interleukin-8 and interleukin-12 levels in patients with ischemic heart disease in a Chinese population.

Increasing evidence has indicated the important roles of inflammation and immune response in the development of atherosclerosis and ischemic heart disease (IHD). We measured the serum interleukin (IL)-8 and IL-12 levels of patients with unstable angina pectoris (UAP) and patients with acute myocardial infarction (AMI), and compared findings with those of normal subjects. The results showed that the serum level of IL-8 was significantly higher in patients with UAP and patients with AMI than in healthy control subjects. To our knowledge, this is the first report that serum IL-12 level was elevated in patients with AMI but not in patients with UAP. These findings suggest that IL-8 and IL-12 are involved in the process of IHD, and serum IL-12 may be a marker for differentiating AMI from UAP.

Isolation of (-)-gossypol from natural plant.

(-)-Gossypol has been isolated from cottonseed of G. barbadense L. Three Gossypium species were studied for the isolation. The study has also revealed a correlation between the optical activity of gossypol isolated and the species of cottonseed used. Gossypol isolated from the species G. barbadense is always found to be levorotatory caused by an excess of (-)-gossypol, whereas that from the species G. hirsutum is always dextrorotatory caused by an excess of (+)-gossypol. Results of most samples (cultivars) showed that optical purity of gossypol isolated from G. barbadense varied from 10-25%, while that from G. hirsutum varied from 10-20%. This is the first report of (-)-gossypol occurring naturally.

PIP: Both (+ and -)-gossypol and (+)-gossypol have been found to be naturally occurring, while no plant producing (-)-gossypol has to date been located. This study isolated (-)-gossypol from the cottonseed of Gossypium barbadense L. Cottonseed from G hirsutum L and G arboreum L was also investigated. The (-)-gossypol content was consistently higher than the (+) gossypol content for all 16 sample of G barbadense studied, while the (+)-gossypol content was higher in the 10 G hirsutum L samples and the 1 G arboreum L sample. The rotation property of gossypol was mainly correlated with the species of the cottonseed; the area where the cottonseed was cultivated had no effect. Gossypol isolated from G barbadense was always levorotatory as a result of the excess of (-)-gossypol, whereas that from the other 2 species studied was always dextrorotatory due to the excess of (+)-gossypol. The optical purity of gossypol isolated from G barbadense ranged from 10-25%, and that from G hirsutum varied from 10-20%.

Application of urinary mutagen testing to detect workplace hazardous exposure and bladder cancer.

The objectives of this biochemical epidemiologic case-control study were to evaluate urinary mutagen testing for occupational exposure assessment, and for possible screening for bladder cancer in the workplace. Thirty-seven patients (19 bladder cancer cases and 18 controls) completed a questionnaire. Two urine samples, i.e. a work sample taken while at work, and a home sample, were requested from each patient. Twenty-six patients (17 cases and 9 controls) gave a total of 47 24-h urine samples for mutagenicity testing by the Ames test. A positive Ames test was found to be associated significantly with current occupation with hazardous exposure (odds ratio = 3.7, 95%CI 1.1-12.9), and non-significantly with bladder cancer (odds ratio = 1.8, 95%CI 0.5-7.1). Our results show that the urinary Ames test has the potential of being used as a surveillance for current workplace hazardous exposure (sensitivity = 52%, specificity = 77%, positive predictive value = 72%, negative predictive value = 59%, positive likelihood ratio = 2.3), but not as a screening test for bladder cancer cases (sensitivity = 42%, specificity = 71%, positive predictive value = 3%, negative predictive value = 98%, positive likelihood ratio = 1.5).

The effect of gossypol on the frequency of DNA-strand breaks in human leukocytes in vitro.

Gossypol, a human antifertility agent isolated from the cotton plant, was found to induce a dose-dependent increase in the frequency of DNA-strand breaks in human leukocytes exposed to 2-40 micrograms/ml of the drug for 1 h in serum-free medium in vitro. DNA-strand breaks were studied by alkaline elution or alkaline unwinding of DNA followed by hydroxylapatite-chromatography. No decrease of gossypol-induced DNA-strand breaks was observed after post-treatment incubation times up to 24 h, whereas X-ray-induced DNA breaks disappeared within 2 h under the same incubation conditions. Cells exposed to gossypol in the presence of 10% fetal calf serum showed no or little increase of DNA breaks, suggesting that serum proteins inhibit the DNA-damaging activity of the drug. Both optical isomers of gossypol induced DNA-strand breaks. However, the effect of (-)-gossypol was only about half of that of (+)-gossypol and the racemic form. The induction and persistence of DNA-strand breaks by gossypol, as well as the reduction of this effect in the presence of serum should be considered in the evaluation of the potential in vivo genotoxicity of the drug.

Large-scale resolution of gossypol enantiomers for biological evaluation.

Gossypol has been resolved into its pure optical isomers by conversion into the Schiff's base derivative of (+)-phenylalanine methyl ester, normal or reverse phase chromatography and hydrolysis. Forty grams of pure (-)-gossypol has been prepared in a micronised form for assessment of its antifertility and toxicological effects.

PIP: There is a requirement for multigram quantities of the gossypol enantiomers to confirm claims of the antispermatogenic and antitumor properties of gossypol's (-) isomer. The authors have resolved gossypol into its pure optical isomers by conversion into the Schiff's base derivative of (+)-phenylalanine methyl ester and used normal or reverse phase chromatography and hydrolysis to assess its antifertility and toxicologic effects. 40 grams of pure (-)-gossypol were obtained and tested in adult male Golden Syrian hamsters. The 40 grams of resolved (-)-gossypol was dissolved in ethanol and the solution poured slowly into cold water. When administered at a dosage of 8 mg/kg/day, (-)-gossypol produced the same antifertility effects as twice that dose of racemic gossypol-acetic acid. The (+) isomer was without antifertility effect at the same dose. The observation of an enantioselective effect of the gossypol isomers on male fertility is significant in that it offers the possibility of reducing the drug dosage by half, perhaps minimizing side effects. In addition, the availability of 2 compounds that are chemically identical but differ in their biologic properties provides a valuable pair of probes. They can be used to examine gossypol's mechanism of action and distinguish between effects that are general properties of gossypol's reactive phenolic and aldehydic groups and effects that are specific properties related to the antifertility and antitumor activity of the (-) isomer.

Inhibition by (+) and (-) isomers of gossypol of testosterone release from mouse Leydig cells in vitro.

Racemic (+/-) mixtures of gossypol isomers exert an antifertility effect by inhibiting sperm motility and spermatogenesis. Purified (+) gossypol has been shown to be without these actions. In this study pure preparations of both (+) and (-) gossypol were found to inhibit, in a similar manner, both basal and LH-stimulated release of testosterone by isolated Leydig cells at concentrations down to 21 microM. It is possible that use of low doses of pure (-) gossypol could inhibit fertility with less endocrine side effects.

Effects of storage and cooking on the iodine content in iodized salt and study on monitoring iodine content in iodized salt.

In order to ensure that the intake of iodine from iodized salt is adequate, the effects of cooking, storage and iodination on iodine content in iodized salt have been studied. For monitoring the analytical performance, a quality control examination was also undertaken. The loss of iodine was greater when salt was stored in plastic bag than in glass bottle. The loss was greater in fortified salt stored at 37 degrees C and under 76% humidity than in that at 20-25 degrees C and under lower humidity. The retention of iodine varied with the kind of foods and also was influenced by the water content of cooked food. In general, the retention of iodine during cooking varied considerably (from 36.6% to 86.1%). The iodine concentration in salts varied greater from 3.0 to 100.3 mg/kg in salt for markets, and from 0 to 90.0 mg/kg in salts for households. 48.3% of samples from markets were found to be in compliance with national standards (30-50 mg/kg), and 72.0% of samples from households were in compliance with national standard (20-50 mg/kg). Analytical data collected from 8 of the cooperative laboratories for an analytical reference material showed a 95% confidence interval of the population mean for both precision and accuracy, falling within X +/- 2SD and passing quality control examination.

[A histopathological study of bone marrow in acute myeloid leukemia. Bone marrow biopsy changes before chemotherapy and comparison with bone marrow smears].

Histopathological changes of pretreatment bone marrow biopsy from 42 cases with acute myeloid leukemia (AML) were described. A considerable difference was shown between the results of aspirate smears and the findings of plastic embedded biopsy sections, particularly in bone marrow cellularity such as infiltration of inflammatory cells and presence of residual hemopoietic cells, qualitative and quantitative abnormalities of megakaryocytes suggestive of myelodysplastic features were more accurately assessed in the sections of marrow biopsy than in the aspirate smears. In three cases there was considerable infiltration of maturing but dysplastic granulocytic cells and erythroid precursors in the sections, but not in the aspirate smears. Our study shows that plastic embedded biopsy sections provide more information than aspiration smears for the diagnosis of AML.